Prott F J, Haverkamp U, Willich N, Wagner W, Micke O, Pötter R
Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Westfälische Wilhelms-Unversität, Münster, Germany.
Bull Cancer Radiother. 1996;83 Suppl:115s-21s. doi: 10.1016/0924-4212(96)84895-x.
The indication for neutron therapy in the treatment of malignant tumors is often uncertain. We therefore would like to present our experience of neutron therapy for different tumors in different localizations and discuss the indications for radiotherapy with neutrons. In Münster, 269 patients were treated with neutrons between 1985 and 1995, via a deuterium-tritium generator with an energy of 14 MeV. The tumors, treated mainly with neutrons, were 64 adenoid cystic carcinomas of the salivary glands, 42 soft tissue sarcomas, 37 rectal cancer recurrences and 20 recurrences in the head and neck region. Furthermore, patients with non adenoid cystic carcinomas of the salivary glands as well as ten other tumor sites also received this treatment, mainly with palliative intent. The 64 patients with adenoid cystic salivary gland tumors had either an unresectable primary tumor, an unresectable recurrence or residual tumor (R1, R2) after surgery. These patients showed complete remission in 78% and partial remission in 22%. The 2-year survival rate was 76%. Forty-two patients with soft tissue sarcomas after resection (R1, R2) and different gradings had an overall survival rate after 5 years of 53%. The 37 patients with rectal cancer recurrence experienced rapid pain relief in nearly 90% of cases. In agreement with the results in the literature, there seems to be an indication for neutron therapy in cases of unresectable primaries, unresectable recurrences or residual tumor after surgery in adenoid cystic carcinomas. Results regarding soft tissue sarcoma treatment with neutrons seem to show superiority in comparison with photon therapy. The treatment with neutrons of rectal recurrences has a very good palliative effect. The radiotherapy treatment with neutrons in all the other tumors did not demonstrate any proven superiority in comparison with photon radiation.
中子疗法在恶性肿瘤治疗中的适应证往往不明确。因此，我们想介绍我们对不同部位不同肿瘤进行中子疗法的经验，并讨论中子放射治疗的适应证。在明斯特，1985年至1995年间，通过一台能量为14兆电子伏的氘 - 氚发生器，对269例患者进行了中子治疗。主要采用中子治疗的肿瘤有64例涎腺腺样囊性癌、42例软组织肉瘤、37例直肠癌复发以及20例头颈部复发肿瘤。此外，涎腺非腺样囊性癌患者以及其他10个肿瘤部位的患者也接受了这种治疗，主要是出于姑息治疗目的。64例涎腺腺样囊性肿瘤患者，要么有不可切除的原发性肿瘤，要么有不可切除的复发肿瘤，要么术后有残留肿瘤（R1、R2）。这些患者的完全缓解率为78%，部分缓解率为22%。2年生存率为76%。42例软组织肉瘤患者术后（R1、R2）且分级不同，5年总生存率为53%。37例直肠癌复发患者中，近90%的病例疼痛迅速缓解。与文献结果一致，对于不可切除原发性肿瘤、不可切除复发肿瘤或腺样囊性癌术后残留肿瘤的病例，似乎有中子疗法的适应证。与光子疗法相比，中子治疗软组织肉瘤的结果似乎显示出优势。中子治疗直肠癌复发具有非常好的姑息效果。与光子辐射相比，中子对所有其他肿瘤的放射治疗未显示出任何已证实的优势。
